Conlon P J, O'Neill S, O'Neill G, Kelly F, Donohoe J
Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland.
Clin Nephrol. 1994 Feb;41(2):83-5.
Recombinant human erythropoietin (EPO) is an effective and safe therapy for correction of anemia in end-stage renal disease (ESRD). Clinical trials reported to date suggest that EPO improves anemia in over 90% of hemodialysis patients with anemia (Eschbach 1989). Factors which have been identified that appear to inhibit the effectiveness of EPO are infection [Muirhead N et al. 1990], iron deficiency, hyperparathyroidism, aluminium excess [Casati 1991] and persistent GIT bleeding. The development of reticulocytosis in response to EPO in the absence of a rise in hematocrit should alert the clinician to the possibility of either hemolysis or occult blood loss. We present a case in which, despite the development of a reticulocytosis of 5% in response to EPO and the absence of hemolysis, we had difficulty in identifying the presumed source of blood loss.
重组人促红细胞生成素（EPO）是治疗终末期肾病（ESRD）贫血的一种有效且安全的疗法。迄今为止报道的临床试验表明，EPO可改善90%以上贫血血液透析患者的贫血状况（Eschbach，1989年）。已确定的似乎会抑制EPO疗效的因素包括感染[Muirhead N等人，1990年]、缺铁、甲状旁腺功能亢进、铝过量[Casati，1991年]以及持续性胃肠道出血。在血细胞比容未升高的情况下，对EPO产生反应而出现网织红细胞增多应提醒临床医生存在溶血或隐匿性失血的可能性。我们报告一例，尽管对EPO产生反应出现了5%的网织红细胞增多且无溶血情况，但我们仍难以确定推测的失血来源。
